The verruca – to treat or not to treat?

How do you know if you definitely have a verruca?

Before beginning this discussion, how do you know if what you’re looking at is actually a verruca? Well a verruca is a wart but termed as such if it appears on the sole of the foot. It is similar to a corn in appearance and both often have overlying callus (hard skin). However, on closer inspection, the skin line pattern (striae) will be interrupted and there may be an appearance of small black spots (small blood vessels) within the lesion. You could also do a simple pinch test. If it is painful to squeeze the lesion, it is most likely a verruca.

Crucially, a corn is simply a build-up of dead skin cells with a hard nucleus, whereas, a verruca is a viral infection. It is one of the most common viral infections of the skin and is caused by the papilloma virus. This verucca virus flourishes in all sorts of environments and can be picked up and transmitted by humans.

How do you catch a verruca?

The favourable environment requires warmth and moist surrounding and that is why a verruca is often transmitted in gyms, common bathrooms and swimming pools.

For a verruca to develop, the virus must enter the skin through an abrasion or a small wound. A verruca may occur as single or multiple or indeed as a mosaic pattern.

In itself, the condition is with no symptoms therefore, is it actually necessary to treat it? A verruca is known to have a life span of about two years. Therefore, if you are not unduly distressed by its presence, you might decide to let nature take its course and hope it will disappear by itself – owing to natural immunity. However, if it is positioned on a weight bearing area, it can be very uncomfortable and indeed painful, so treatment becomes significant.

What are the treatment options?

The best way to treat a verruca is to prevent it from occurring in the first place. When visiting swimming baths, it is wise to make sure that there is no small lesion on your foot. If you find such a lesion, cover it with a waterproof plaster. Also make sure to wear flip-flops in order to create a barrier.

There are many products that can be found over the counter, however, if in doubt or you have vascular problems, diabetes, rheumatology, neuropathy it is best practice to seek professional advice from a podiatrist. However, do not under-estimate the verruca. At times it can be very difficult to destroy it and it may just not respond to any kind of treatment.

A popular choice for self treatment would be a topical solution containing salicylic acid such as Occlusal. The acid works by breaking down keratin, a protein which forms part of the skin structure. This results in the shedding of skin cells from the affected area over a period of time. If successful, the new skin which grows underneath will be healthy.

For persistant verrucaes, a podiatrist may undertake cryosurgery, freezing the verruca over a number of applications to eradicate it. Deemed a last resort, surgery would be the most aggressive treatment undertaken by a dermatologist.

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